Paediatric doctors error rate in detection of paediatric elbow injuries in Rahima Moosa mother and child hospital

Magano, Gopolang
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Introduction: Elbow fractures are common paediatric injuries that are often misdiagnosed. Quality imaging and accurate interpretation is essential to avoid complications that can result in growth disturbance. Aim: The aim of this study was to determine error rates of elbow injuries by medical doctors in paediatric department in Rahima Moosa Mother and Child Hospital. Methods: 28 doctors participated in the study. 20 preselected radiographs (10 normal and 10 abnormal) were projected in a power point slide show. The doctors completed a tick sheet to assess whether the x-ray was normal or not. This was followed by a 20 minute tutorial on the approach to paediatric elbow x-rays. Following that, the same images were projected in a different sequence and with a more detailed tick sheet for the readers to evaluate. Results: The detection rate of elbow fractures by paediatric doctors was poor. Although there was an improvement in the detection of fractures before (52.1%) and after (56.4%) the tutorial, the difference was not statistically significant (paired t-test; p=0.16). Conclusion: The paediatric elbow is a common site where pathology is missed on x-rays. The study showed that the detection rate of elbow fractures by the paediatric doctors is poor, even after a tutorial on the radiological features. We recommend on-going inservice training of clinicians to improve detection of fractures.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in Diagnostic Radiology. Johannesburg, 2019